Chien, C.H., Liu, K.L., Chien, H.T., & Liu, H.E. (2013). The effects of psychosocial strategies on anxiety and depression of patients diagnosed with prostate cancer: A systematic review. International Journal of Nursing Studies.
To evaluate, by means of meta-analysis and systematic review, evidence regarding the effectiveness of psychosocial interventions for anxiety and depression in patients with prostate cancer
Databases searched were PubMed, CINAHL, PsycINFO, Cochrane Collaboration, and two Chinese databases.
A study was included in the review if it
A study was excluded if it focused on disease other than prostate cancer and lacked intergroup comparison.
Patients were undergoing multiple phases of care.
Findings suggest that psychosocial interventions can be helpful in reducing anxiety and depression, at various time points in the cancer trajectory, for men who are newly diagnosed with prostate cancer. Positive effects were generally short-term only.
Findings of this analysis suggest that various types of psychosocial interventions can help reduce anxiety and depression in men with prostate cancer. Effects shown tended to be short-lived. Nurses can help reduce anxiety and depression among patients with prostate cancer by using psychosocial types of strategies. Information about ways to sustain this effect is limited, and the analysis does not identify the types of approaches that are the most helpful. Further exploration of longer-term sustainable effects and associated dosage and intervention frequency is needed. Given the relatively low level of quality of research in this area, more well-designed studies are needed.
Chiarioni, G., Whitehead, W.E., Pezza, V., Morelli, A., & Bassotti, G. (2006). Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia. Gastroenterology, 130, 657–664.
To assess long-term (24-month) efficacy of biofeedback versus laxatives and bowel education.
Biofeedback training was provided in five 30-minute classes over five weeks. Similarly, laxative plus bowel education was provided in five 30-minute bowel training classes over five weeks. Those patients also took 14.6 to 22.9 g/kg of polyethylene glycol for the first six months; after six months, patients took the dose BID.
Tertiary gastroenterology clinic in Verona, Italy
This was a randomized, controlled trial.
Biofeedback should be the treatment of choice for PFD-induced constipation.
Chiarioni, G., Salandini, L., & Whitehead, W.E. (2005). Biofeedback benefits only patients with outlet dysfunction, not patients with isolated slow transit constipation. Gastroenterology, 129, 86–97.
To compare the efficacy of biofeedback in pelvic function dyssynergia–induced constipation (PFD) versus slow transit constipation (STC).
All subjects received five weekly biofeedback lessons and were assessed at 1, 6, 12, and 24 months.
Gastroenterology Clinic of the Division of Gastrointestinal Rehabilitation of the University of Verona in Valeggio sul Mincio, Italy
This was a quasi-experimental study.
At six months, greater improvements were seen in patients with PFD compared to those with STC: 71% versus 8% reported improved satisfaction (p = 0.001), and 76% versus 8% reported three or more bowel movements per week (p ≤ 0.001).
Patients with PFD received greater benefit from biofeedback than those with STC.
Chi, K.H., Chiou, T.J., Li, C.P., Chen, S.Y., & Chao, Y. (2014). MS-20, A chemotherapeutical adjuvant, reduces chemo-associated fatigue and appetite loss in cancer patients. Nutrition and Cancer, 66, 1211–1219.
To examine the effects of MS-20, a fermented soybean extract, on quality of life, fatigue, and appetite for patients with cancer receiving chemotherapy (Immunologic and antioxidant profiles were also examined.)
MS 20 was taken orally on an empty stomach at a dose of 5 mL in the morning and 3 mL in the afternoon diluted in 100 mL of warm water. Patients were randomly assigned to receive MS 20 during either the first or second chemotherapy cycle after a one to two-week washout period. The study duration was eight weeks. Patients were evaluated at weekly office visits.
Randomized, unblended, crossover trial
Physical functioning scores were significantly better during treatment with MS 20 (p = .023). VAS scores for fatigue and appetite loss improved significantly while taking MS 20 (p < .001); however, fatigue and appetite loss scales on the EORTC questionnaire showed no significant difference between study conditions. There were no measurable effects on immunological parameters examined in the study.
Findings were mixed regarding the effect of MS 20 on fatigue and appetite loss.
This study provides some mixed findings regarding the effect of MS 20, a fermented soybean extract, on fatigue and anorexia in patients during chemotherapy.
Chew, C., Ritchie, M., O'Dwyer, P. J., & Edwards, R. (2011). A prospective study of percutaneous vertebroplasty in patients with myeloma and spinal metastases. Clinical Radiology, 66, 1193–1196.
To assess the outcome and complication rate of percutaneous vertebroplasty in a large cohort of consecutive patients with myeloma and spinal metastasis treated over a nine-year period
Patients with cancer who were experiencing intractable pain from metastasis and vertebral collapse and were unresponsive to oral analgesia underwent percutaneous vertebroplasty. Pain and function were measured prior to and six weeks after the procedure.
This was a single-site study conducted in the United Kingdom.
This was a prospective, intervention trial.
Vertebroplasty can be considered as a possible option for patients with myeloma or spinal metastasis to help with intractable pain and physical disability.
Cheville, A.L., Sloan, J.A., Northfelt, D.W., Jillella, A.P., Wong, G.Y., Bearden III, J.D., . . . Loprinzi, C.L. (2009). Use of a lidocaine patch in the management of postsurgical neuropathic pain in patients with cancer: A phase III double-blind crossover study (N01CB). Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 17(4), 451–460.
To investigate the efficacy of one or more lidocaine patches in reducing incisional pain
In the initial four-week treatment phase, patients received either lidocaine patches or placebo to apply to postsurgical incisional sites. After four weeks, the lidocaine group received placebo and vice versa. Pain was rated at baseline and at four and eight weeks.
Double-blind, randomized, two-period crossover trial
Pain interference scores were significantly lower in the group that received lidocaine patch first. Significant differences in postsurgical pain intensity, with the lidocaine patch applied to incisional areas, were lacking overall.
Further research is needed to determine whether lidocaine patches augment the analgesic regimen for incisional pain.
Cheville, A.L., Kollasch, J., Vandenberg, J., Shen, T., Grothey, A., Gamble, G., & Basford, J.R. (2013). A home-based exercise program to improve function, fatigue, and sleep quality in patients with stage IV lung and colorectal cancer: A randomized controlled trial. Journal of Pain and Symptom Management, 45, 811–821.
To report the effects of a strength training and walking program in patients with stage IV lung and colorectal cancer.
Patients were given usual care or 1.5 hours of training by a physical therapist on rapid, easy, strength training exercises (REST) and pedometer-based walking using an instruction manual, resistance bands, an exertion rating scale, and a study log. They were then followed bimonthly by telephone for eight weeks.
Patients were undergoing the end of life phase of care.
The study was a single-blinded, randomized, controlled trial.
Mobility, fatigue, and sleep measures were statistically significant between the intervention and control groups from baseline to week 8 (p = 0.002, p = 0.03, and p = 0.002, respectively), in favor of exercise. Other measures did not show significance. The number of REST sessions and weeks logged with step counts were associated with changes in the mobility score. Survival and withdrawals did not differ significantly between the groups.
A home-based intervention using walking and strength exercises may improve mobility, fatigue, and sleep quality in patients with stage IV colorectal or lung cancer.
The teaching of walking exercises and strength routines may improve functioning in this patient population in terms of mobility, sleep quality, and fatigue. The one-time education session may be appealing to nurses looking for a timely intervention to help improve these symptoms.
Cheville, A. L., Girardi, J., Clark, M. M., Rummans, T. A., Pittelkow, T., Brown, P., . . . Gamble, G. (2010). Therapeutic exercise during outpatient radiation therapy for advanced cancer: feasibility and impact on physical well-being. American Journal of Physical Medicine & Rehabilitation, 89, 611–619.
To describe the feasibility of delivering a structured physical therapy (PT) program as part of a multidisciplinary intervention to patients undergoing outpatient radiotherapy for advanced cancer.
Patients were randomly assigned to receive the structured intervention or standard care using a stratified approach based on Eastern Cooperative Oncology Group (ECOG) performance status, age, sex, and tumor type. The structured multidisciplinary intervention consisted of eight sessions delivered by a PT and a psychiatrist or a psychologist with facilitation provided by an advanced practice nurse, licensed social worker, or certified hospital chaplain depending on the theme. Cognitive, emotional, social, and spiritual dimensions of the intervention centered on specific topics and coping strategies related to patients' goal setting, challenging negative thoughts, communication, and hope. PT sessions incorporated education and provision of printed material, truncal and upper-limb strengthening exercises, and lower-limb strengthening alternating between standing and seated exercises. These were performed with resistance provided by elastic bands. Aerobic conditioning was not included, although patients were encouraged to engage in regular physical activity. Standard care consisted of regular assessment of treatment toxicities. Patients were not counseled regarding the potential benefits of exercise.
This report focused on the PT and interdisciplinary structured intervention aspects of a previously reported study (Rummans et al. 2006).
The study was a single-blind, randomized, controlled trial.
The structured intervention appeared to provide short-term improvement in overall perception of well-being; however, this effect was not sustained over the duration of the trial.
Cheung, Y.L., Molassiotis, A., & Chang, A.M. (2003). The effect of progressive muscle relaxation training on anxiety and quality of life after stoma surgery in colorectal cancer patients. Psycho-Oncology, 12, 254–266.
To examine progressive muscle relaxation training (PMRT) in reducing anxiety and improving quality of life in patients with colorectal cancer after stoma surgery
PMRT was provided for 20 minutes along with deep breathing (10 major muscle groups were used, but not valsalva response). Participants received two teaching sessions and practiced at home for 10 weeks. Measurements were taken during hospitalization and 5 and 10 weeks after surgery and intervention.
The study reported on a sample of 59 participants.
The sample was recruited from the department of surgery of two public hospitals in Hong Kong.
A longitudinal randomized controlled trial design was used.
R-ANOVA indicated there was a significant difference in state-anxiety over the 10 weeks between the two groups (p < 0.01), with the experimental group reporting a significantly lower state-anxiety level than the control group. Also, scores significantly decreased over time (10 weeks) in both groups (p < 0.001), indicating a 43% decrease.
Cheuk, D.K., Chiang, A.K., Lee, T.L., Chan, G.C., & Ha, S.Y. (2011). Vaccines for prophylaxis of viral infections in patients with hematological malignancies. Cochrane Database of Systematic Reviews, 3, CD006505.
To determine the effectiveness and safety of viral vaccines in patients with hematologic malignancies. The primary outcome was the incidence of infection. Secondary outcomes were mortality, incidence of complications, severe viral infection, hospitalization, immune response, and adverse effects.
Databases searched were the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and CINAHL (June 2010). In addition, reference lists of relevant articles, abstracts from scientific meetings, and contacted vaccine manufacturers were used.
Randomized, controlled trials (RCTs) evaluating viral vaccines in patients with hematologic malignancies were included. No exclusion criteria were stated.
A total of 565 references were retrieved.
Relative risk (RR) was used for binary data, and mean difference (MD) was used for continuous data. The fixed-effect model was used in meta-analyses. Two authors (first and second authors) independently reviewed titles and abstracts of references retrieved from the searches and selected all potentially relevant studies. Copies of these articles were obtained and reviewed independently by the same authors against predefined inclusion criteria. The authors were not blinded to the names of the trial authors, institutions, or journal of publication. All disagreements about the selection of studies were resolved by consensus.
Interventions evaluated included heat-inactivated varicella-zoster virus (VZV) vaccine (two trials), influenza vaccines (five trials), and inactivated poliovirus vaccine (IPV) (one trial).
Patients were undergoing the active treatment phase of care.
The VZV vaccine might reduce herpes zoster compared with no vaccine (relative risk [RR] = 0.54; 95% confidence interval [CI] [0.3, 1.0]; p = 0.05). Vaccination also demonstrated efficacy in immune response but frequently caused local adverse effects. One trial reported a severity score of zoster that favored vaccination (MD = 2.6; 95% CI [0.94, 4.26]; p = 0.002). Two RCTs compared inactivated influenza vaccine with no vaccine and reported a lower risk of lower respiratory infections (RR = 0.39; 95% CI [0.19, 0.78]; p = 0.008) and hospitalization (RR = 0.17; 95% CI [0.09, 0.31]; p < 0.00001) in vaccine recipients. However, vaccine recipients more frequently experienced irritability and local adverse effects. There was no significant difference in seroconversion between one and two doses of influenza vaccine (one trial), or between recombinant and standard influenza vaccine (one trial), or influenza vaccine given with or without reinduction chemotherapy (one trial). The IPV trial comparing vaccination starting at 6 versus 18 months after stem cell transplantation (SCT) found no significant difference in seroconversion.
Inactivated VZV vaccine might reduce zoster severity in adult SCT recipients. Inactivated influenza vaccine might reduce respiratory infections and hospitalization in adults with multiple myeloma or children with leukemia or lymphoma. Local adverse effects occur frequently.
The quality of evidence is low.
Further high-quality RCTs are needed.